News

Hospital loses £8.5m in NHS fines

York Hospital has lost £8.5 million of vital funding in NHS fines because of controversial Government targets, it has been revealed.

A total of £6 million of the loss was due to the so-called marginal tariff set by the Labour Government due to concerns about A&E departments becoming swamped over the last ten years.

The surge in admissions is believed to be due to the growing elderly population and increasing frustration at GPs’ new out-of-hours arrangements.

The tariff lays down that for every patient the trust admits beyond the figure in 2008, the hospital will only be paid 30 per cent of the cost of looking after that patient.

The other 70 per cent of the cash stays within the NHS – which decides how it should be spent through its new Clinical Commissioning Groups.

Last year, York lost £6 million under the marginal tariff, plus £2.5 million in fines for readmitting patients it had discharged, but who then needed further treatment.

Health bosses have admitted than rather than going to help patients, the money has simply disappeared in settling NHS debts.

York hospital staff are up in arms that the hospital is being docked money simply for looking after a growing number of people.

Chief executive Patrick Crowley said: “The £6 million would pay for six wards’ worth of nurses. In any one year, that would pay for 50 to 60 consultants. It would pay for some desperately needed capital investment.”

The CCGs are supposed to spend the money on initiatives to prevent patients landing up at hospital in the first place.

But Mr Crowley said that because of the state of local NHS finances he understood why the money was not being invested.

He agreed that in the York area, the 70 per cent was “just disappearing”.

“But I don’t say that in any way critically,” he added.

“We have commissioning groups which are working in deficit with financial difficulties and therefore choices are incredibly limited. The inability to invest that 70 per cent is a function of the environment we are working in.”

The claims were made in a Channel 4 Dispatches programme which featured York Hospital as a typical A&E.

The night before the recording, York Hospital had been forced to turn away patients to other casualty departments in Leeds, Hull and Scarborough for the first time in its 30-year history.

The programme claimed that hospitals nationwide had missed out on £1 billion over the past three years due to the tariff and other missed targets.

Dr Steve Crane, a consultant in York A&E, said: “You try to juggle as many patients as you can in a system which is broken. It has been broken for a very long time because there has not been enough investment in it either financially but also investment from the point of view of thinking clearly about what patients’ care and out-of-hours care needs may be."

An NHS Vale of York CCG spokesman said: “The programme discussed the marginal rate tariff. This Government policy gives healthcare systems an incentive to prevent admissions.

“The CCG can confirm that if it was able to ring-fence funds under the marginal rate policy, it would primarily be invested in out-of-hospital care projects to prevent hospital admissions, leading to funds being channelled to other areas of healthcare.

"The CCG acknowledges that to date it has not yet been able to invest in this way but it sees its work to deliver services closer to where patients live as a positive step forward in helping to alleviate pressures on the hospital.

Comments (7)

What's the point of fining the hospital? surely all this does is to deprive the hospital of much needed funds to treat ordinary people who need to use the service, thereby hurting sick people.

There must be a different way surely? how about holding those in high positions and earning huge salaries at the hospital to account? Perhaps reduce their salaries by a set amount if the performance falls?

I bet things would soon improve then!

What's the point of fining the hospital? surely all this does is to deprive the hospital of much needed funds to treat ordinary people who need to use the service, thereby hurting sick people.
There must be a different way surely? how about holding those in high positions and earning huge salaries at the hospital to account? Perhaps reduce their salaries by a set amount if the performance falls?
I bet things would soon improve then!Thecynic

i was kept in a couple of nights extra when i had surgery and its only just clicked that this must have been down to this re-admittance fine. I felt really bad for people around me as I was perfectly well to go home on antibiotics but they insisted they needed to keep me in on the drip for an extra 2 nights... such a waste of bed.....

i was kept in a couple of nights extra when i had surgery and its only just clicked that this must have been down to this re-admittance fine. I felt really bad for people around me as I was perfectly well to go home on antibiotics but they insisted they needed to keep me in on the drip for an extra 2 nights... such a waste of bed.....Archiebold the 1st

The NHS currently invests a tiny proportion of it's resources (Is it 8% or something) in primary and community care - so these are currently run on a shoestring. In the long run a higher proportion needs to be spent in the community and less in hospitals.

However, be careful jumping to conclusions. Although it is fashionable to talk about massive increases going to A&E, the Kings Fund found last year that most of this was simply a different method of counting A&E attendances (they added in 'Walk In Centres and Minor Injuries units all of a sudden).

But, if we accept generally that too many people use A&E, and in theory some of these could be dealt with in the community, then we have to fund community services properly.

Also, we must make sure that the NHS is there for those in genuine need. Is it possible that the service (both GP and A&E) is getting too many minor things that perhaps self-care would be more suitable for?

The NHS currently invests a tiny proportion of it's resources (Is it 8% or something) in primary and community care - so these are currently run on a shoestring. In the long run a higher proportion needs to be spent in the community and less in hospitals.
However, be careful jumping to conclusions. Although it is fashionable to talk about massive increases going to A&E, the Kings Fund found last year that most of this was simply a different method of counting A&E attendances (they added in 'Walk In Centres and Minor Injuries units all of a sudden).
But, if we accept generally that too many people use A&E, and in theory some of these could be dealt with in the community, then we have to fund community services properly.
Also, we must make sure that the NHS is there for those in genuine need. Is it possible that the service (both GP and A&E) is getting too many minor things that perhaps self-care would be more suitable for?yorkshirelad

If Mr crowley is so concerned about the financial state of the nhs...why did he give himself a £30,000 pay rise? How can he justify taking more than the entire annual wage of a nurse as a pay rise?

If Mr crowley is so concerned about the financial state of the nhs...why did he give himself a £30,000 pay rise? How can he justify taking more than the entire annual wage of a nurse as a pay rise?redchick

OK finally I have received my long-waited letter about my complex care pathway which means that I go 'straight' onto the ward in relation to A&E.

I have had problems with A&E sitting there for hours, the consultant not knowing that I was downstairs for hours and hours. The on-call registrar should have been called and also bloods done and admitted. My hot-water bottle rash that never was!

There should be a system for complex patients like myself, I now have a lead clinician.

Goodness knows how many years that has taken and how many years it has taken to 'get' the issues but A&E has been a real issue for me.

Hopefully other patients might have benefit too as really some of us should be being admitted rather than 'discharged'!

But really how many complaint letters have I had to write including the lack of cultures whilst ill - no wonder the hospital has C-difficile with my bugs never being properly diagnosed.

Each time they have been fined!!

I rest my case Mr Cowley now and given that the other hospital have apologised to me time they did too.

Let's not mention how many £ss they wasted on that shaken baby syndrome case recently. Many thousands.

OK finally I have received my long-waited letter about my complex care pathway which means that I go 'straight' onto the ward in relation to A&E.
I have had problems with A&E sitting there for hours, the consultant not knowing that I was downstairs for hours and hours. The on-call registrar should have been called and also bloods done and admitted. My hot-water bottle rash that never was!
There should be a system for complex patients like myself, I now have a lead clinician.
Goodness knows how many years that has taken and how many years it has taken to 'get' the issues but A&E has been a real issue for me.
Hopefully other patients might have benefit too as really some of us should be being admitted rather than 'discharged'!
But really how many complaint letters have I had to write including the lack of cultures whilst ill - no wonder the hospital has C-difficile with my bugs never being properly diagnosed.
Each time they have been fined!!
I rest my case Mr Cowley now and given that the other hospital have apologised to me time they did too.
Let's not mention how many £ss they wasted on that shaken baby syndrome case recently. Many thousands.Digeorge

And not to mention the excess brain scans, the skewed neuro-psychological assessments that stopped the clock long after I finished!

Well as for the alleged 'learning difficulties' I end up getting a very good 2i and at times a 1st in my current law degree. Those law lecturers don't think so! Guess that was a waste of money too and not alone stress that they put me through and that Inquest which A&E diagnosed incorrectly.

And not to mention the excess brain scans, the skewed neuro-psychological assessments that stopped the clock long after I finished!
Well as for the alleged 'learning difficulties' I end up getting a very good 2i and at times a 1st in my current law degree. Those law lecturers don't think so! Guess that was a waste of money too and not alone stress that they put me through and that Inquest which A&E diagnosed incorrectly.Digeorge